Pyelonephritis

Definition:

Pyelonephritis is a type of urinary tract infection that often starts in the lower urinary tract, such as the urethra or bladder, and spreads to the kidney or kidneys. 

Pyelonephritis is considered an important infection that requires appropriate medical treatment and can lead to serious complications, such as permanent damage to the kidneys or bloodstream infection if not properly treated.

Causes:

1- Bacteria in the lower urinary tract: 
The most common cause of pyelonephritis is bacteria entering the lower urinary tract through the urethra, where they multiply and ascend towards the kidneys.
Escherichia coli is one of the most common bacteria responsible for this.
2- Infection spreading from another part of the body and reaching the kidneys through the bloodstream, such as a artifical joint infection.
3- Infection following some surgical procedures performed on the kidney.

Symptoms:

1- Fever and chills.
2-  back , side or groin pain 
3- Burning feeling or pain during urination.
4-  urinary urgency and frequent  urination
5- Nausea and vomiting.
6- Decreased appetite.
7- Fatigue and weakness.
8- Abdominal pain.
9- urine that smells bad 
10- Pus or blood in the urine

Risk factors:

1- Women: 
Women are more predisposed to developing pyelonephritis than men, as their urethra is shorter, allowing bacteria to enter easily from outside the body into the bladder. 
In addition, the proximity of the urethral area to the vagina and anal opening increases that risk.

2- Pregnancy: Pregnant women have a higher risk of developing pyelonephritis due to hormonal changes and the pressure of the fetus on the bladder and kidneys, which slows down the elimination of urine from the body.

3- Urinary tract obstructions, such as kidney stones, pinched urethra , or prostate enlargement.
4- Prostatitis.
5- Weakened immune system: Certain medical conditions such as diabetes or acquired immune deficiency syndrome (AIDS) can weaken the immune system, in addition to the use of certain medications such as immune suppressants during organ transplantation.
6- Neurological injuries: 
Some neurological injuries or spinal cord injuries can mask the pain caused by lower urinary tract infections, giving the bacteria a chance to multiply and ascend to the kidneys.
7- Use of urinary catheters.
8- Vesicoureteral reflux: 
This is a medical condition in which urine flows back from the bladder into the ureters .

Complications:

Failure to treat pyelonephritis properly can lead to serious complications, such as:
1- Chronic kidney disease or kidney failure.
2- Bloodstream infection.
3- pregnancy complications, such as premature birth or having a baby with low birth weight.
4- Emphysematous pyelonephritis, which is a severe and advanced infectious condition that occurs mainly in diabetic patients.

Diagnosis:

Diagnosis primarily relies on analyzing urine samples, in addition to performing urine culture to accurately identify the bacteria causing the infection.

Other investigations, such as ultrasound or computed tomography, may be used according to the treating kidney specialist's discretion.

Treatment:

The mainstay of pyelonephritis treatment is the use of antibiotics to eliminate the bacteria causing the infection. This is often done in a hospital setting, where intravenous antibiotics are used under the supervision of a specialized medical team.

Prevention:

1- Drinking fluids, especially water.
2- Urinating immediately when feeling the need to do so.
3- Urinating and emptying the bladder after sexual intercourse.
4- Wiping the genital area from front to back, not the reverse.
5- Avoiding the use of  Deodorant sprays or douches in the genital area  
6- Avoiding the use of condoms that are coated with spermicides.